Carroll J C, Reid A J, Ruderman J, Murray M A
Department of Family and Community Medicine, University of Toronto, Ontario, Canada.
Fam Med. 1991 Mar-Apr;23(3):184-8.
This retrospective chart review compared the intervention rates in 2,365 low-risk obstetric patients at three urban teaching hospitals, two of which were high-risk, perinatal referral centers. The third cared for mostly low-risk patients. The hypothesis was that rates of intervention in low-risk pregnancies would be higher in the high-risk care environment. Family physicians at the perinatal referral centers performed significantly more artificial rupture of membranes, epidural blocks, augmentations of labor, and episiotomies on their low-risk patients than did those at the low-risk hospital. This trend was also found for obstetricians but did not reach statistical significance. Thus, the conclusion was drawn that caring for low-risk patients in a high-risk care environment is associated with a higher intervention rate by family physicians. Factors that may contribute to this finding are discussed.
这项回顾性病历审查比较了三家城市教学医院中2365名低风险产科患者的干预率，其中两家是高风险围产期转诊中心。第三家医院主要诊治低风险患者。研究假设是，在高风险护理环境中，低风险妊娠的干预率会更高。围产期转诊中心的家庭医生对其低风险患者进行人工破膜、硬膜外阻滞、引产和会阴切开术的比例明显高于低风险医院的医生。产科医生也发现了这种趋势，但未达到统计学显著性。因此，得出的结论是，在高风险护理环境中照顾低风险患者与家庭医生更高的干预率相关。文中讨论了可能导致这一结果的因素。
